Betrayal of Trust: The Collapse of Global Public Health.

• Author: Runyan, Curtis
• Position: New and Noteworthy

Betrayal of Trust: The Collapse of Global Public Health, by Laurie Garrett (New York: Hyperion, 2000). International borders are increasingly permeable, open to the flow of ideas, goods, services--and life-threatening microbes. A jet plane can carry a traveler infected with highly contagious pneumonic plague from India to Europe in a few hours. But around the world public health measures--our best safeguards against the outbreak of deadly epidemics--are in a dismal state, finds Garrett in her lengthy global check-up on our collective public health systems.

Improvements in public health--providing access to nutrition, housing, urban sewage and water systems, and setting up epidemic control measures, swamp drainage and water systems, public education and literacy programs, etc.--account for the vast majority of the last century's gains in life expectancy and declines in death due to infectious disease. Despite these gains, however, support of basic public health measures (which tend to be less visible than medical care and thus underappreciated) has been in decline, often in the face of...